SmithRx

Operations

• Collaborate with clients and Implementation Managers to provide clinical expertise on drug spend and utilization, clinical management strategies, medication alternatives, and formulary compliance
• Serve as a clinical subject matter expert supporting Plan Operations activities
• Act as a clinical liaison between Plan Operations and other internal SmithRx teams
• Explain formulary and clinical program value propositions to clients and internal teams
• Support communications of formulary changes and program updates
• Recommend clinical programs that provide cost savings to clients and members
• Monitor market trends and provide clinical market intelligence
• Communicate drug information and respond to plan-specific clinical inquiries
• Create and update clinical marketing materials for new-group go-live activities
• Analyze data and interpret drug benefit designs
• Communicate analytical and reporting needs to supporting departments

Operations Pharmacist

Pharmacist

• Review and make timely, evidence-based decisions on prior authorizations and appeals using clinical guidelines and benefit criteria
• Ensure compliance with federal, state, and internal regulations across applicable lines of business
• Accurately document clinical decisions and maintain thorough records in accordance with URAC/NCQA utilization review standards
• Provide clear, empathetic support to members, prescribers, and pharmacies by responding to clinical inquiries
• Stay current with clinical prescribing guidelines, internal policies, and regulatory changes
• Follow internal procedures, job aids, and HIPAA guidelines to protect patient privacy and data security
• Identify and report potential fraud, waste, and abuse (FWA)
• Support training and development of new and existing team members
• Assist leadership with special projects, process improvements, and operational initiatives

Clinical Review Pharmacist – Seasonal

Accountant

• Prepare accurate and timely indirect tax filings
• Work with the company’s filing agent to ensure state reports are filed accurately and timely
• Own member reimbursements, including processing physical checks
• Perform month-end reconciliations of the outstanding check list
• Manage the company’s escheatment process
• Clear daily cash transactions
• Prepare comprehensive month-end cash account reconciliations
• Manage corporate credit card activity by coding and booking expenses accurately
• Perform month-end corporate card reconciliations
• Serve as an operational owner within day-to-day accounting functions
• Report directly to the Senior Manager, Corporate Accounting

Staff Accountant

Pricing Analyst

• Analyze, develop, and execute pricing strategies across retail pharmacy, mail pharmacy, specialty, rebate aggregators, and pharmaceutical manufacturers
• Support overall supply chain operations and strategy
• Participate in meetings with supply chain partners to present and explain SmithRx pricing proposals
• Maintain and grow relationships with key pricing and business intelligence supply chain contacts
• Leverage data analytics and economic modeling to support pharmacy benefit proposals
• Analyze market opportunities to identify and open new channels for the sales organization
• Collaborate with Sales, Customer Success, Sales Ops, Partnerships, Analytics, Product, and Marketing teams on pricing strategies
• Build enablement materials including playbooks, cheat sheets, objection-handling guides, and FAQs
• Participate in and facilitate partner meetings presenting SmithRx differentiators and value propositions
• Prepare materials and assist with internal and external training
• Track and demonstrate client value and ROI from strategic partnerships

PBM Network Pricing Strategy Manager

• Complete prior authorization reviews
• Collaborate with pharmacists as part of the P&T process
• Serve as a clinical subject matter expert to support account management, sales, and implementation teams
• Maintain open lines of communication with other functional areas within SmithRx
• Provide effective communication of SmithRx’s vision, mission, values and goals
• Participate in multi-departmental meetings and committees to accomplish projects
• Help optimize SmithRx clinical offerings and outcomes for customers, members and clients

Product Marketing

• Lead overall go-to-market strategy, product positioning, and sales enablement for SmithRx's pharmacy benefits platform
• Shape market perception and educate the industry on a new approach to pharmacy benefits
• Coordinate cross-functional product launches across Product, Clinical Programs, Sales, Customer Success, and Marketing
• Develop GTM strategies and transparent messaging for AI-powered products and features
• Build trust with employers, brokers, and members around AI in healthcare
• Hire, lead, and develop a high-performing product marketing team
• Establish differentiated positioning and messaging for brokers, HR leaders, members, and clinical partners
• Create sales enablement programs and product documentation including pitch decks, case studies, battlecards, and solution handbooks
• Set product marketing goals, monitor GTM initiatives, and report campaign performance and product adoption to senior management
• Conduct buyer and end-user research to influence the product roadmap and prioritize feature development
• Oversee competitive analysis and identify strategic opportunities
• Partner with Growth and Brand Marketing on campaign narratives, partnerships, and co-marketing campaigns to drive pipeline and brand awareness

Director, Product Marketing

• Assist members, providers, pharmacies, and internal SmithRx teams with prescription complexities and timely coverage of clinically appropriate, cost-effective medication therapy
• Coordinate clinical review cases and check coverage and plan rules
• Verify submitted information and conduct pharmacy and provider outreach
• Review prior authorization requests within established protocols
• Triage and troubleshoot questions and escalations
• Verify eligibility and drug coverage to determine appropriate claims processing
• Triage clinical review for prior authorization requests at different levels
• Review prior authorization requests using criteria, claims history, and plan benefit rules
• Organize and prioritize requests for timely prior authorization case management
• Build and adjust authorizations in the claim adjudication system
• Navigate drug products and formulations and perform basic calculations to monitor accurate claims adjudication
• Coordinate outreach across teams and help guide processes and protocols
• Evaluate member clinical situations against medication policies and approve or triage cases to a Pharmacist for denial
• Determine when medications require internal or external review
• Contact selected external stakeholders for approval on drugs with dollar limits

Pharmacy Technician – Seasonal

Customer Support

• Serve as the main point of contact for TPAs during new group implementations
• Gather TPA requirements, including contacts, due dates, account structures, group numbers, invoicing, ID cards, and eligibility files
• Document requirements in standard project templates and tools
• Maintain detailed project plans and open-items logs
• Coordinate daily tasks for Implementation Managers and/or Specialists
• Support data entry for new group implementations
• Build client profiles using the CRM tool
• Liaise between contracting, invoicing, and Implementation teams
• Provide go-live support to implementation staff and TPAs
• Participate in post-go-live discussions to improve performance
• Participate throughout the new group implementation lifecycle
• Participate in internal and external client meetings
• Organize high-volume tasks and meet deadlines and project milestones
• Ensure attention to detail across project requirements
• Take initiative and multitask effectively

Implementation Support Specialist

Account Executive

• Establish and maintain relationships for large complex accounts
• Own and facilitate the end-to-end renewal process
• Maintain accountability for client satisfaction
• Lead internal teams and act as an internal client advocate
• Provide executive updates on client status and risks
• Represent Customer Success in finalist meetings
• Analyze pharmacy claims data to identify trends and provide cost-containment recommendations
• Deliver quarterly and annual business reviews (QBRs)
• Create and maintain client strategic action plans
• Partner with clinical pharmacists to present formulary changes and clinical program recommendations
• Monitor drug pipelines, legislative changes, and competitive PBM landscapes
• Review QBRs, reporting, and client communications for executive-ready quality
• Coordinate with Implementation, Operations, and Pricing teams to resolve member issues and ensure seamless service delivery
• Mentor Account Managers, Account Specialists, and Account Coordinators
• Maintain current knowledge of client organizations, products, services, news, and changes
• Maintain and update client records
• Develop working relationships with Pharmacy Operations, service partners, and client contacts
• Communicate important client account activities to cross-functional partners
• Prioritize issues and assess escalations that may create client attrition risk
• Travel up to 25%

Account Executive – Pharmacy Benefits

• Verify eligibility and drug coverage under plan benefit designs to determine appropriate claims processing
• Triage clinical review processes for prior authorization requests according to established protocols
• Review prior authorization and similar requests using criteria, claims history, and plan benefit rules
• Conduct prescriber and pharmacy outreach to verify and gather required information
• Organize and prioritize multiple requests for timely prior authorization case management
• Build and adjust authorizations within the claim adjudication system
• Navigate drug products and formulations and perform basic calculations to monitor accurate claims adjudication
• Assess and synthesize multiple workflows to make sound clinical decisions
• Coordinate outreach across teams and address questions and escalations
• Evaluate member clinical situations against medication policies and approve or triage cases to a Pharmacist for denial
• Determine when medications require internal or external review
• Contact selected external stakeholders for approval on drugs with dollar limits